Gestão regional no enfrentamento à pandemia da Covid-19: estudo de casos em São Paulo / Regional management in the face of the COVID-19 pandemic: case study in São Paulo

RESUMO Ao final do ano de 2019 o mundo foi surpreendido pela Covid-19, que chegou ao Brasil no início de 2020, fazendo com que o Sistema Único de Saúde (SUS) adotasse estratégias imediatas para atender as necessidades de saúde da população, colocando em evidência todos os obstáculos que o sistema de saúde vinha enfrentando nos últimos anos. O estado de São Paulo não foi diferente do restante do País em relação ao enfrentamento. Este estudo objetivou identificar as principais estratégias adotadas em 5 regiões de saúde de São Paulo, com foco na gestão regional, analisando os processos e práticas adotados para o enfrentamento à pandemia da Covid-19. Tratou-se de um estudo qualitativo, realizado através de estudo de casos múltiplos, com abordagem exploratória, a partir de pesquisa de campo e realização de oficinas regionais. As regiões de saúde deste estudo puderam comprovar a importância da intersetorialidade nas ações de saúde como um todo. Notou-se o grande papel dos municípios nestas ações e a união destes, fortalecendo o papel da regionalização e ampliando a importância da governança em saúde. Ademais, as regiões de saúde saíram fortalecidas porque exerceram seu papel de liderança e organizaram ações junto aos municípios.

ABSTRACT At the end of 2019 the world was surprised by COVID-19, which arrived in Brazil at the beginning of 2020, causing the Unified Health System (SUS) to adopt immediate strategies to meet health needs, as well as putting in check all the obstacles that the health system has been facing in recent years. In the state of São Paulo it was not different from the rest of the country in relation to the confrontation. This study aimed to identify the main strategies adopted in 5 health regions of São Paulo, focusing on regional management, analyzing the processes and practices adopted to face the COVID-19 pandemic. It was a qualitative study, carried out through a multiple case study, with an exploratory approach, based on field research and regional workshops. In this study, the health regions were able to prove the importance of intersectoral actions in the health system. It was noted the great role of municipalities in these actions and their union, strengthening the role of regionalization and expanding the importance of governance in health. In addition, the health regions were strengthened because they exercised their leadership role and organized actions with the municipalities.

Diferencias e influencia en la Conducta Adaptativa por las regiones colombianas

La presente investigación tuvo por objetivo describir las diferencias e influencia de las regiones colombianas en las Habilidades Adaptativas Específicas y Dominios de la Conducta Adaptativa en niños colombianos entre 0-15 años, sin alteraciones en el neurodesarrollo y sin etiología de daño cerebral. Participaron padres y profesores de 2081 niños, divididos por 4 regiones geográficas: Andina, Caribe, Orinoquía y Pacífico. Se aplicó el cuestionario de conducta adaptativa ABAS-II en sus versiones Infantil padres a los padres de niños de 0 a 1,11 años, y las versiones escolar padres y escolar profesores a los padres y profesores de niños de 2 a 15 años. Los resultados indicaron que existen diferencias estadísticamente significativas entre los menores de las diferentes regiones, siendo los resultados más altos los de la región Pacífico y los más bajos los de la región Orinoquía. Con estos resultados se considera que es importante tener en cuenta los aspectos culturales, sociales, ambientales e históricos de cada región del país para la evaluación de su conducta adaptativa, entendiendo que estas diferencias no marcan o indican mayor susceptibilidad a patología, sino variaciones culturales dentro de los términos considerados como lo esperado.

The present research aimed to describe the differences and influence of Colombia geographic regions on Specific Adaptive Skills and Domains of Adaptive Behavior in Colombian children between 0-15 years of age without neurodevelopmental alterations and without etiology of cerebral disease. 2081 Colombian children´s parents and teachers participated, divided into 4 regions: Andean, Caribbean, Orinoquía and Pacific. The ABAS-II questionnaire was applied the chindren´s parent version to parents of children from 0 to 1,11 years and the school parents`and school teachers` versions to parents and teachers of children from 2 to 15 years of age. The results indicated that there are statistically significance differences between the children of the different regions, the highest results being those of the Pacific region and the lowest those of the Orinoquía region. It is considered with the results that it is important to take into account the cultural, social, environmental and historical aspects of each region of the country for the evaluation of their adaptive behavior; these differences do not mark or indicate greater susceptibility to pathology, but rather cultural variations within of the terms considered as the expected.

The challenges faced after a major trauma at an expedition ship at a remote area. Report of one Case / Desafíos enfrentados después de un trauma mayor en un barco de expedición en un área remota. Informe de un caso

The challenges of practicing medicine in small ships on remote sites involve limited resources, lack of specialized support, and longer interactions with a patient in an isolated environment. This report describes the successful management of a patient who suffered a major injury after fell from the stairs in an expedition ship in the Southern Ocean in the Antarctic route. The patient was managed by the onboard physician for four days until the medical evacuation was possible.

Los desafíos de practicar la medicina en barcos pequeños en sitios remotos implican recursos limitados, falta de apoyo especializado e interacciones más prolongadas con el paciente en un entorno aislado. Este manuscrito describe el manejo exitoso de un paciente quien sufrió un trauma mayor producto de una caída en un barco de expedición en el Océano Austral en la ruta Antártica. El paciente fue manejado por el médico de a bordo durante cuatro días hasta que fue posible realizar la evacuación médica.

Preliminary study on the distribution of T cell receptor β chain in patients with Takayasu arteritis / 中华风湿病学杂志

Objective:To investigate the diversity of T cell receptor repertoire in patients with Takayasu arteritis and analyze the side chain gene expression and distribution pattern of V、J gene rearrangement of T cell receptors.Methods:The peripheral blood samples of 8 patients with Takayasu arteritis and 4 healthy controls were collected. After constructing the library, high-throughput sequencing was performed with Illumina hiseq X10 sequencer. Bioinformatics analysis was conducted to obtain the sequences and compared with the reference sequences. the frequency information of V/D/J genes, and extraction of CDR region sequenceswere compared. The diversity of the TCR repertoire was also evaluated, and the comparative analysis and cluster analysis between groups and within samples were carried out. The data were analyzed by R language statistical software. Comparisons between two groups were analyzed by Mann-Whitney U test. Results:There was no significant difference in D50 index and Shannon entropy of chain CDR3 between Takayasu arteritis group and healthy control group. There was no significant difference in high-frequency cloning between the two groups. However, a total of 21 gene rearrangement fragments were different between the two groups. The expression of 14 V/J gene rearrangement fragments such as TRBV15-TRBJ2-3 [0.31 (0.27, 0.70) ], TRBV26-TRBJ2-6[0.30 (0.23, 0.57) ], TRBV28-TRBJ1-4[179 (139, 412) ], TRBV28-TRBJ1-6[362 (253, 419) ] in the patient group was significantly higher than that in the control group ( Z score were 2.65, 2.08, 2.27, 2.27, 2.27, 2.08, 2.65, 2.08, 2.27, 2.27, 2.08, 2.08, 2.46 and 2.22 respectively, P<0.05). The expression of seven V/J gene rearrangement fragments such as TRBV10-1-TRBJ1-2 [7.49 (4.9, 12.1) ],TRBV29-1-TRBJ2-2[10.5 (4.0, 12.8) ], TRBV-4-2-TRBJ2-6 [3.31 (1.8, 5.8) ] in the patients with Takayasu arteritis group was significantly lower than that in the control group ( Z score were -2.08, -2.27, -2.08, -2.08, -2.27, -2.08 and -2.29, P<0.05). Conclusion:Although there is no significant decrease in the diversity of peripheral blood TCR repertoire in patients with Takayasu arteritis, there are differences in the expression of chain V and J genes of TCR genes, and there is unique V/J rearrangement clones.

Protective effects of three kinds of borneol on different brain regions in acute cerebral ischemia/reperfusion model rats / 中国中药杂志

This study compared the ameliorating effects of L-borneol, natural borneol, and synthetic borneol on the injury of different brain regions in the rat model of acute phase of cerebral ischemia/reperfusion(I/R) for the first time, which provides a reference for guiding the rational application of borneol in the early treatment of ischemic stroke and has important academic and application values. Healthy specific pathogen-free(SPF)-grade SD male rats were randomly assigned into 13 groups: a sham-operation group, a model group, a Tween model group, a positive drug(nimodipine) group, and high-, medium-, and low-dose(0.2, 0.1, and 0.05 g·kg~(-1), respectively) groups of L-borneol, natural borneol, and synthetic borneol according to body weight. After 3 days of pre-administration, the rat model of I/R was established by suture-occluded method and confirmed by laser speckle imaging. The corresponding agents in different groups were then administered for 1 day. The body temperature was monitored regularly before pre-administration, days 1, 2, and 3 of pre-administration, 2 h after model awakening, and 1 d after model establishment. Neurological function was evaluated based on Zea-Longa score and modified neurological severity score(mNSS) 2 h and next day after awakening. The rats were anesthetized 30 min after the last administration, and blood was collected from the abdominal aorta. Enzyme-linked immunoassay assay(ELISA) was employed to determine the serum levels of tumor necrosis factor-alpha(TNF-α), interleukin-6(IL-6), IL-4, and transforming growth factor-beta1(TGF-β1). The brain tissues were stained with triphenyltetrazolium chloride(TTC) for the calculation of cerebral infarction rate, and hematoxylin-eosin(HE) staining was used for observing and semi-quantitatively evaluating the pathological damage in different brain regions. Immunohistochemistry was employed to detect the expression of ionized calcium binding adapter molecule 1(IBA1) in microglia. q-PCR was carried out to determine the mRNA levels of iNOS and arginase 1(Arg1), markers of polarization phenotype M1 and M2 in microglia. Compared with the sham-operation group, the model group and the Tween model group showed significantly elevated body temperature, Zea-Longa score, mNSS, and cerebral infarction rate, severely damaged cortex, hippocampus, and striatum, increased serum levels of IL-6 and TNF-α, and decreased serum levels of IL-4 and TGF-β1. The three borneol products had a tendency to reduce the body temperature of rats 1 day after modeling. Synthetic borneol at the doses of 0.2 and 0.05 g·kg~(-1), as well as L-borneol of 0.1 g·kg~(-1), significantly reduced Zea-Longa score and mNSS. The three borneol products at the dose of 0.2 g·kg~(-1) significantly reduced the cerebral infarction rate. L-borneol at the doses of 0.2 and 0.1 g·kg~(-1) and natural borneol at the dose of 0.1 g·kg~(-1) significantly reduced the pathological damage of the cortex. L-borneol and natural borneol at the dose of 0.1 g·kg~(-1) attenuated the pathological damage of hippocampus, and 0.2 g·kg~(-1) L-borneol attenuated the damage of striatum. The 0.2 g·kg~(-1) L-borneol and the three doses of natural borneol and synthetic borneol significantly reduced the serum level of TNF-α, and the 0.1 g·kg~(-1) synthetic borneol reduced the level of IL-6. L-borneol and synthetic borneol at the dose of 0.2 g·kg~(-1) significantly inhibited the activation of cortical microglia, and 0.2 g·kg~(-1) L-borneol up-regulated the expression of Arg1 and down-regulated the expression level of iNOS. In conclusion, the three borneol products may alleviate inflammation to ameliorate the pathological damage of brain regions of rats in the acute phase of I/R by inhibiting the activation of microglia and promoting the polarization of microglia from M1 type to M2 type. The protective effect on brain followed a trend of L-borneol > synthetic borneol > natural borneol. We suggest L-borneol the first choice for the treatment of I/R in the acute phase.

A survey of Stomoxys Geoffroy, 1762 (Diptera: Muscidae) in eight administrative regions of Cameroon

ABSTRACT Stomoxys Geoffroy, 1762 are major livestock pests in the tropics and are common in diverse habitats. This study aims to conduct a survey on the Stomoxys fauna of Cameroon. From 2015 to 2017, entomological studies using standard traps (n=204) were conducted in eight administrative regions found in five agro-ecological zones (AEZs) of Cameroon with 606 trap-points over 22,032 traps days. A total of 77,804 Stomoxys specimens were collected, with eight taxa consisting of six species (S. calcitrans (Linnaeus, 1758), S. omega Newstead, Dutton & Todd, 1907, S. xanthomelas Roubaud, 1937, S. inornatus Grunberg, 1906, S. transvittatus Villeneuve, 1916, and S. sitiens (Rondani, 1873)) and two subspecies (Stomoxys niger niger Macquart, 1851 and S. niger bilineatus Grunberg, 1906) identified. Among all the recorded taxa, S. calcitrans and S. n. niger were present in five and seven of the eight regions respectively, but S. sitiens was rare and only found in the North. Furthermore, the highest species number (seven out of eight) was recorded in the Guinee savanna of the Adamawa region. The highest apparent density range of 101 to 200 Stomoxys/ trap/ day (s/t/d) was recorded in the Sudan savanna AEZ of the Far North region. Stomoxys occurred in all the AEZs in eight regions, some of which are major cattle rearing regions. This represents risk for the mechanically transmission of dangerous pathogens in those regions.

Maternal A90V mutation in the PreS1 gene of sub-genotype C2 hepatitis B virus is associated with intrauterine transmission

ABSTRACT PreS/S gene mutations could impact virus secretion, infection and immune evasion. However, the relationship between PreS/S mutations and intrauterine transmission has not yet been clarified. Thus, we aimed to explore the associations between PreS/S gene mutations of HBV isolated from mothers and intrauterine transmission. We analyzed the mutations of PreS/S regions of the HBV genome in mothers with HBV DNA levels ≥ 106 IU/mL whose neonates experienced HBV intrauterine transmission (transmission group, GT) and those whose neonates did not experience intrauterine transmission (control group, GC) analyzed using clone-based sequencing. In total, 206 sequences were successfully amplified, including 98 sequences (from 21 mothers) from GT and 108 sequences (from 20 mothers) from GC of genotype C for mutational analysis. Among the 1203 nucleotides of PreS/S regions, there were 219 (18.20%) base substitutions, of which 103 (47.03%) base mutations caused amino acid changes. F80S, A90V and I68T were mutation hotspots. Mothers in GT had a higher mutation rate of A90V in the PreS1 gene than mothers in GC. The A90V mutation increased the risk of HBV intrauterine transmission after adjusting the maternal age and the mode of delivery (OR = 6.23, 95% CI: 1.18-32.97). Moreover, the area under the ROC curve (AUC) for intrauterine transmission due to A90V and a combination of A90V with the mode of delivery were 0.723 (95% CI: 0.575 to 0.891, P = 0.011) and 0.848 (95% CI: 0.723 to 0.972, P < 0.001), respectively. Mothers with the A90V mutation in the PreS1 gene may be a potential risk factor for HBV intrauterine transmission.

Clinicopathological characteristics and prognosis of non-Hodgkin lymphoma in oral and maxillofacial regions: An analysis of 369 cases / 北京大学学报(医学版)

OBJECTIVE@#To investigate the clinicopathological characteristics and factors influencing the prognosis of non-Hodgkin lymphoma (NHL) in oral and maxillofacial regions.@*METHODS@#Clinicopathological data of 369 patients with oral and maxillofacial NHL initially diagnosed in Peking University Hospital of Stomatology from 2008 to 2020 were collected and analyzed retrospectively.@*RESULTS@#There were 180 males and 189 females. The median age of the patients was 56 years (3 months to 92 years), and the median duration was three months. Clinically, 283 cases manifested as mass, 38 cases as ulcerative necrotizing lesions, and 48 cases as diffuse soft tissue swelling. The lesions of 90 cases located in face and neck (75 cases neck, 20.3%), 99 cases were of major salivary glands (79 cases parotid glands, 20.9%), 103 cases of oral cavity, 50 cases of maxillofacial bones, 20 cases of Waldeyer's ring, and 7 cases of infratemporal fossa. In the study, 247 of the 369 patients had cervical lymphadenopathy, only 40 cases had B symptoms, and 23 cases had the bulky disease. Of the 369 NHLs, 299 (81%) were B-cell NHL, and 70(19%) were T-cell NHL. Diffuse large B-cell lymphoma, extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue, follicular lymphoma, and extranodal natural killer (NK)/T-cell lymphoma nasal type were the most common pathological subtypes. According to Ann Arbor staging, 87, 138, 106, and 38 cases were classified as staged Ⅰ, Ⅱ, Ⅲ, Ⅳ, respectively. The me-dian follow-up time was 48 months, 164 patients died during the follow-up period. The overall survival rates for one year, two years, and five years were 90.1%, 82.4%, and 59.9%, respectively, and the median survival was (86.00±7.98) months. Multivariate analysis showed that age (P < 0.001), Ann Arbor staging (P < 0.001), elevated lactate dehydrogenase (P=0.014), and pathological subtype (P=0.049) were the independent factors influencing the overall survival rate of NHL patients.@*CONCLUSION@#Oral and maxillofacial NHL has unique clinical characteristics and distribution patterns of pathological subtypes. Fewer patients had systemic symptoms. Neck and parotid glands were the most common sites invaded by NHL. Advanced age, Ann Arbor stage Ⅲ-Ⅳ, B symptoms, and T-cell NHL may predict a poor prognosis in oral and maxillofacial NHL patients.

Analysis on the characteristics of rural blood donation population in Dali Bai Autonomous Prefecture / 中国输血杂志

【Objective】 To explore the status and characteristics of voluntary blood donors in rural areas of Dali Bai Autonomous Prefecture (referred as Dali), and to provide basis for scientific and effective voluntary blood donation in rural population in regions inhabited by ethnic groups. 【Methods】 The data of rural blood donors who donated blood in Dali from 2010 to 2019 were collected, including demographic data as nationality, gender, age, educational background, as well as the blood donation frequency and blood infection screening (index) results. The above data of urban blood donors who donated blood in Dali during the same period were selected to investigate the increasing trend of blood donation rate. SPSS26.0 was used for statistical analysis of the collected data of rural and urban blood donation population. 【Results】 From 2010 to 2019,the number of blood donors in Dali increased from 13 949 to 19 479,with an increasing rate of 39.64%. The number of rural blood donors increased from 2 623 to 8 727,among which the number of ethnic minority groups increased from 1 779 to 5 059.The ratio of male to female blood donors was 70.30% (1 844/2 623) vs 29.70% (779/2 623) in 2010,56.37% (4 919/8 727) vs 43.63%(3 808/8 727) in 2019. Those with educational level of junior middle school or below were the most, accounted for 43.97%(38 443/85 836),with ethnic donors of 24.47%(23 583/85 836). The proportion of donors aged between 36 and 45 was the highest[40.73% (30 477/74 827) ], with ethnic donors of [28.56% (21 374/74 827), and the proportion of repeated blood donors was 54.87%(35 279/64 299),with ethnic donors of 49.89%(18 080/36 240) [the proportion of repeated blood donors in urban donors in the same period was 48.13% (55 677/115 675) ] (P0.05). 【Conclusion】 It is of great significance to explore the characteristics of blood donors in rural areas (especially regions inhabited by ethnic groups) and the reasons for disqualification, in order to scientifically carry out the recruitment of voluntary blood donors and further promote blood donation for rural residents

Impacto indirecto de COVID-19 en las tasas de incidencia de enfermedades transmitidas por vector en México / Indirect impact of COVID-19 on the incidence rates of vector-borne diseases in Mexico

Resumen Introducción: La distribución espacial y temporal de la infección por SARS-CoV-2 sobrepasa las áreas endémicas de enfermedades transmitidas por vector (ETV), cuya vigilancia en México ha cambiado sustancialmente a partir del primer caso confirmado de COVID-19. Objetivos: Estimar y comparar las tasas de incidencia de las ETV antes y después de la introducción del SARS-CoV-2 en México. Métodos: Estudio retrospectivo de casos de ETV de 2014 a 2021. Las tasas de incidencia de cada ETV en el periodo previo (2014-2019) y posterior (2020-2021) a la introducción del SARS-CoV-2 en México fueron calculadas y comparadas. Resultados: Antes de la introducción del SARS-CoV-2, las tasas de incidencia de las ETV fueron altas y posterior a la introducción del coronavirus hubo un descenso en los índices epidemiológicos; sin embargo, solo se identificó diferencia estadística significativa en la tasa de incidencia de la malaria (p ≤ 0.05) y otras rickettsias (p ≤ 0.05). Conclusiones: Algunas medidas para reducir los casos de COVID-19, como el distanciamiento social, el confinamiento domiciliario, la reducción en el aforo en el transporte público y el trabajo en casa, probablemente contribuyeron a disminuir temporalmente el número de casos de las ETV; sin embargo, puede haber rebrote de las ETV en el futuro cercano.

Abstract Introduction: SARS-CoV-2 infection spatial and temporal distribution overlaps with endemic areas of vector-borne diseases (VBD), whose surveillance in Mexico has substantially changed since the first COVID-19 confirmed case. Objectives: To estimate and compare the incidence rates of VBDs before and after the introduction of SARS-CoV-2 in Mexico. Methods: Retrospective study of VBD cases from 2014 to 2021. The incidence rates of each VBD in the period before (2014-2019) and after (2020-2021) the introduction of SARS-CoV-2 in Mexico were calculated and compared. Results: Before the introduction of SARS-CoV-2, the incidence rates of VBDs were high and after the introduction of coronavirus there was a decrease in epidemiological indices; however, there was only statistically significant difference in the incidence rate of malaria (p ≤ 0.05) and other rickettsiae (p ≤ 0.05). Conclusions: Some measures to reduce COVID-19 cases, such as social distancing, home confinement, reductions in public transport and working at home (home office), probably temporarily decreased the number of VBD cases; however, there may be a resurgence of VBDs in the near future.

COVID 19 INFECTION IN A PATIENT NEWLY DIAGNOSED WITH HIV/TB COINFECTION – A CASE REPORT

HIV/TB coinfection, COVID 19 with HIV/TB, immune reconstitution inflammatory syndrome (IRIS), TB lymphadenopathy

Cytogenetic analysis of two species of genus Protosticta from Himachal Pradesh, India

Cytogenetically, out of 262 species, only three species of family Platystictidae has been reported worldwide. Present study has been undertaken to study chromosome complement and its characterization of more species of this family. Cytogenetic analyses of Protosticta sanguinostigma Fraser, 1992 and Protosticta uncata Fraser, 1931 of family Platystictidae, collected from Andretta, Himachal Pradesh, India have been carried out on the basis of conventional staining, C-banding and silver nitrate staining. Both the species possess n=13m as haploid chromosome number and X0-XX sex determining mechanism. One large bivalent is present in all the meiotic stages of P. sanguinostigma which is considered as the species specific character. Chromosome complement of both the species shows variation in distribution of C-bands and Nucleolar organizer regions (NORs). Cytologically, both the species have been described for the first time.

Determination of Vitamin Contents of Maize (Zea mays L) Produced and Stocked from Rural Conditions in Cote D’ivoire

Aims: Maize is prized for its richness in nutrient compounds. Despite its socio-economic importance, maize faces a quality problem that is sometimes very delicate. Indeed, maize during different production, post-harvest processing, storage and transport conditions is exposed to bio-aggressors that can alter the quality of this cereal. With this in mind, this study was conducted to determinate the vitamins contents of maize produced and stored in five maize-producing regions of Côte d’Ivoire. Study Design: A total of 1 500 samples of maize as grains, epis and spathes were collected at rate of 500 samples by region (Gbêkê, Poro, Hambol, Indénié-Djuablin and Gontougo) and sent to the laboratory for analysis of the vitamin contents. Place and Duration of Study: This study was carried out during March 2016 to January 2017. Then, the analyses of the collected sample took place at the Biotechnology, Agriculture and Valorisation of Biological Ressources Laboratory of the Félix Houphouët-Boigny’s University, Abidjan. Methodology: Vitamins determination was carried by High Performance Liquid Chromatography. A total of twelve vitamins were evaluated namely 9 water-soluble vitamins (thiamin, riboflavin, niacin, choline, pantothenic acid, pyridoxine, biotin, folic acid and cobalamin) and 3 fat-soluble vitamins (β-carotene, vitamin E and K). Results: Results show a significant difference between vitamins contents of the different maize forms and regions. The mean values ranged from 0.09 ± 0.04 to 557.24 ± 10.97 mg / kg for water-soluble vitamins and from 0.31±0.25 to 4.20±1.00 mg / kg for fat-soluble vitamins. Choline was the most abundant of the water-soluble vitamins while β-carotene and vitamin E were the most abundant of the fat-soluble vitamins. Maize grains and epis had the highest levels of these vitamins all of the regions. Maize spathes samples, especially those from Indénié-Djuablin and Gontougo, showed the lowest concentrations. Conclusion: A significant variability from one region to another can be noticed at level of vitamins regardless the type of maize. Maize vitamin contents seem to be related to maize form (grains, epis, spathes), maize variety, agronomic practices, post-harvest treatments and storage structure.

Comparison of Indices to Estimate Heat Exposure to Human: A Review in Tropical Regions

@#Workplaces in tropical countries are associated with increasing temperature and humidity, thus, the workers are susceptible to heat hazards. The inability for self-cooling properly toward exposure to head hazards can lead to severe dehydration and even death. To date, there are several indices and models to assess heat stress, such as WBGT, ISO 7933, discomfort index, HIS, PhSI, etc. However, their accuracy and suitability for tropical regions are still under investigation since they are mostly developed for subtropical regions. This review assessed the indices to estimate heat exposure in tropical regions based on the various online database. Among those indices, WBGT is the most suitable despite its inability to estimate human thermal response in tropical regions with several adjustments. Based on this review, it showed that there is a need for improvement of current indexes to be used in tropical regions since they are more suitable for the subtropical countries.

Heterogeneity across skin sites in atopic dermatitis / 中华皮肤科杂志

Atopic dermatitis (AD) is a highly heterogeneous skin disease. The subtypes of AD classified by age, severity and inflammatory patterns have been widely accepted previously; however, the heterogeneity in skin lesions across different body sites has been rarely addressed. Most recently, it has been found that the efficacy of dupilumab varies across different body sites, suggesting different patterns of inflammation in skin lesions at different body sites. Thus, this article proposes the concept of heterogeneity across body sites in AD, summarizes cell biological features and microbiome at different skin sites under physiological conditions, analyzes clinical manifestations of, multi-omic study results from and treatment response of AD at different sites, and discusses pathogenesis of AD, providing a basis for individualized therapy of AD.

Detection rate and clinical significance of regions of homozygosity in prenatal genetic diagnosis / 中华妇产科杂志

Objective:To detect the incidence and analyze the clinical significance of regions of homozygosity (ROH) through the single nucleotide polymorphism array (SNP array).Methods:The SNP array detection results of 5 116 pregnant women in the Third Affiliated Hospital of Guangzhou Medical University from January 2016 to December 2020 were retrospectively analyzed. The pregnant women with ROH (5 Mb as the threshold) were followed up to analyze the relationship between ROH and abnormal fetal phenotype. Whole exon sequencing was performed in 4 cases of consanguineous marriage to detect potential recessive causative genes in the ROH region.Results:(1) A total of 39 cases of ROH were detected, with a positive rate of 0.76% (39/5 116). Among them, 25 cases (64%, 25/39) were detected only on single chromosome, and chromosome 11 had the highest detection rate, suggesting the risk of uniparental disomy; fourteen cases (36%,14/39) were detected on multiple chromosomes, most commonly on chromosomes 11, 1, 3, 4 and 8. (2) The number of cases and detection rate of ROH detected by different prenatal diagnosis indicators were as follows: 12 cases (1.78%, 12/676) in pregnant women with abnormal non-invasive prenatal testing result, 12 cases (0.37%, 12/3 284) in pregnant women with ultrasound abnormality, 4 cases (4/4) in pregnant women with consanguineous marriage, 3 cases (0.92%, 3/326) in pregnant women with previous adverse pregnancy, 2 cases (1.15%, 2/174) in pregnant women with high risk of serology in screening, 2 cases (4.00%, 2/50) in pregnant women with abnormal fetal chromosomal karyotype, 2 cases (0.79%, 2/253) in pregnant women with advanced maternal age, 1 case (0.56%, 1/178) in pregnant women with related parental genetic factors and 1 case (0.58%, 1/171) in pregnant women with the other factors. (3) The follow-up results of 39 cases of prenatal ROH showed that there were 16 cases of term birth, 15 cases of termination of pregnancy, 2 cases of preterm births, 1 case of fetal death and 5 cases lost to follow-up.Conclusions:Chromosomal ROH phenomenon is not rare. By analyzing the detection rate of ROH in prenatal diagnosis, combined with the results of fetal phenotype and postpartum follow-up, the clinical characteristics of ROH are discussed, so as to better understand the relationship between ROH and its phenotype.

Analysis of difficult-to-treat sites in patients with psoriasis who received biological therapy / 中华皮肤科杂志

Objective:To investigate difficult-to-treat sites in patients with psoriasis receiving biological therapy.Methods:Clinical data were retrospectively collected from 73 adult patients with psoriasis in the database of Psoriasis Center, National Clinical Research Center for Skin and Immune Diseases from June 2020 to September 2021, who had received sufficient and standardized treatment with biological agents for ≥ 24 weeks, and were still treated with biological agents at the time of enrolment into this study with the psoriasis area and severity index (PASI) score being 1 - 5 at the time of enrolment into the database of Psoriasis Center. Distribution of psoriatic lesions resistant to biological therapy were analyzed, and differences in refractory sites were compared between different biologics. Chi-square test or Fisher′s exact test was used to analyze differences in the anatomical distribution of residual skin lesions after treatment with different biologics, McNemar test to compare the anatomical distribution of skin lesions before and after biological therapy, and Kruskal-Wallis H test to analyze the association between PASI scores for residual skin lesions and dermatology life quality index (DLQI) scores. Results:After ≥ 24 weeks of sufficient and standardized biological therapy in the 73 patients, refractory skin lesions mostly involved the lower limbs (46 cases, 63.01%) , followed by the scalp (36 cases, 49.32%) and upper limbs (27 cases, 36.99%) ; proportions of patients with residual skin lesions on the face and neck, trunk, upper limbs, lower limbs, hands and feet significantly decreased after biological therapy compared with those before treatment (paired χ2 = 5.14, 7.69, 9.90, 4.17 and 6.13, P = 0.016, 0.003, 0.001, 0.031 and 0.008, respectively) , while there was no significant difference in the proportions of patients with skin lesions on the scalp and genital areas before and after treatment (both P > 0.05) . No significant difference in the anatomical distribution of residual skin lesions was observed between the 13 patients receiving treatment with tumor necrosis factor inhibitors (adalimumab, infliximab, or tumor necrosis factor receptor-antibody fusion protein) and 59 receiving treatment with interleukin-17 (IL-17) inhibitors (secukinumab or ixekizumab) (all P > 0.05) . There was no significant difference in the anatomical distribution of residual skin lesions in the 13 patients before and after the treatment with tumor necrosis factor inhibitors (all P > 0.05) ; in the 59 patients treated with IL-17 inhibitors, the proportions of patients with residual skin lesions on the trunk, upper limbs, hands and feet significantly decreased after treatment (paired χ2 = 4.90, 9.09 and 7.11, P = 0.021, 0.001 and 0.004, respectively) , while there was no significant difference in the distribution of skin lesions on the scalp, face and neck, lower limbs and genital area before and after treatment (all P > 0.05) . Among the 73 patients, the PASI scores for lesions on the upper and lower limbs and the total PASI scores were all associated with the DLQI scores ( H = 7.52, 12.61, 6.75, respectively, all P < 0.05) , and were significantly higher in the patients with DLQI scores of > 10 points than in those with DLQI scores of ≤ 5 points (all P < 0.05) . Conclusions:Biological therapy-resistant psoriatic lesions were mostly located on the scalp, and refractory skin lesions mostly involved the lower limbs, scalp and upper limbs. No significant difference in the anatomical distribution of residual skin lesions was observed between patients treated with tumor necrosis factor inhibitors and IL-17 inhibitors, but IL-17 inhibitors may result in lesion clearance at more anatomical sites compared with tumor necrosis factor inhibitors.

Variability in reference for serum metabolomics profiles among healthy Han people in different regions of China / 中华内分泌代谢杂志

Objective:To establish the reference for serum metabolomics profiles among healthy Han adults in China, and explore the variation on metabolomics profiles by geographic regions, sex, and age.Methods:Cross-sectional data and serum samples were obtained from the China National Health Survey. A total of 1 039 male and 1 032 female healthy adults(≥30 years) were included in this study. Serum metabolomics analyses were conducted with ultra-performance liquid chromatography-mass spectrometry(UPLC-MS). Orthogonal partial least squares discriminant analysis(OPLS-DA) was performed to compare the differences of metabolomics among different region, sex, and age.Results:Significant differences on metabolomics profiles were identified among region, sex, and age. A total of 114 region-related metabolites were spotted, including 53 metabolites that involved in human metabolic pathways, mainly peptides(20 metabolites) and glycerophospholipid metabolism-related(14 metabolites). Fifty-nine metabolites were pinned down to be sex-related, among which cotinine was significant in all 7 provinces. Age-related metabolites were only found in Shaanxi and Hainan, with 22 metabolites were recognized.Conclusion:Serum metabolomics varies by geographic regions, sex, and age. When metabolomics is applied for diagnosis or biomarker screening in various studies, it shall take into consideration of setting tailored references.

Occurrence and identification of Penicillium and Talaromyces species from beach sand

Aims@#Penicillium and Talaromyces were among the species of microfungi that inhabit beach sand in Batu Ferringhi Beach, Penang Island, Malaysia. Previously, Talaromyces was described as the sexual stage of Penicillium, but both are now accepted as separate genera based on molecular phylogeny. The aim of the present study was to identify species of Penicillium and Talaromyces that are present in beach sand in Malaysia.@*Methodology and results@#Species identities were confirmed according to similarities of the internal transcribed spacer regions and β-tubulin gene sequences and a phylogenetic analysis based on both regions/gene. Nine Penicillium spp. were identified as P. georgiense, P. chermesinum, P. pimiteouiense, P. citrinum, P. oxalicum, P. daleae, P. rolfsii and Penicillium sp. and the four Talaromyces spp. were T. siamense, T. atroroseus, T. minioluteus and T. fusiformis.@*Conclusion, significance and impact of study@#These findings showed that beach sand harboured a variety of Penicillium and Talaromyces species. The occurrence of Penicillium and Talaromyces in beach sands is associated with the organic matter in the sand, which provides suitable substrates and nutrient sources. Due to this, beach sand might harbour many potentially pathogenic or opportunistic species that may pose a health concern to immunocompromised individuals.

Determination of the relationship among cell proliferation, metabolic activity and stage of pregnancy by AgNORs as markers in bovine placenta / Determinación de la relación entre la proliferación celular, la actividad metabólica y la etapa de preñez por los AgNOR como marcadores en la placenta bovina

SUMMARY: Nucleolus Organizer Regions (NORs) are defined as nucleolar components containing argyrophilic proteins selectively stained by silver methods (AgNORs). Several investigations have shown the AgNOR quantity and area represent a valuable parameter of cell kinetics, since they reflect the level of activity and cellular proliferation. This article addresses an evaluation of the functional activity and relation between days of pregnancy and proliferative capacity of trophoblastic mononucleate and binucleate cells from bovine placentomes. Both the number and size of AgNORs were determined in different phases of gestation by silver nitrate staining in conventional histological slides. The results showed a significant increase (from 1 to 12 AgNORs) in the number of AgNORS per trophoblastic mononucleate cell in the 3rd trimester, with predominance of 4-6 AgNORs/cell. In the 1st and 2nd trimesters, the number ranged between 1 and 9 AgNORs/cell, with predominance of 1-3 AgNORs. No significant differences were observed between the 2nd and 3rd trimesters, but in the first, in binucleate cells (19-27 and 10-18 AgNORs/cell, respectively) - this number was higher than the one registered in trophoblastic mononucleate cells in the same period. Thus, AgNORs can be used as markers of the proliferative placental cell cycle and established a relation between number of AgNORs and days of gestation. This relation can be used for diagnoses and prognoses of several placental pathologies, including pregnancy losses from manipulated embryos.

RESUMEN: Las Regiones Organizadoras de Nucléolos (NOR) se definen como componentes nucleolares que contienen proteínas argirofílicas teñidas selectivamente por métodos de plata (AgNOR). Varias investigaciones han demostrado que la cantidad y el área de AgNOR representan un parámetro importante de la cinética celular, ya que reflejan el nivel de actividad y proliferación celular. Este trabajo analiza la actividad funcional y la relación entre los días de preñez y la capacidad proliferativa de las células trofoblásticas mononucleadas y binucleadas de placentomas bovinos. Tanto el número como el tamaño de los AgNOR se determinaron en diferentes fases de la gestación mediante tinción con nitrato de plata en portaobjetos histológicos convencionales. Los resultados mostraron un aumento significativo (de 1 a 12 AgNOR) en el número de AgNORS por célula mononucleada trofoblástica en el tercer trimestre, con predominio de 4-6 AgNOR / célula. En el primer y segundo trimestre, el número osciló entre 1 y 9 AgNOR / célula, con predominio de 1-3 AgNOR. No se observaron diferencias significativas entre el 2do y 3er trimester; en el primer trimestre, en células binucleadas (19-27 y 10-18 AgNORs / célula, respectivamente) - este número fue superior a la cantidad registrada en células mononucleadas trofoblásticas en el mismo período. Por tanto, los AgNOR se pueden utilizar como marcadores del ciclo celular placentario proliferativo y se establece una relación entre el número de AgNOR y los días de gestación. Esta relación puede ser útil en el diagnóstico y pronóstico de varias patologías placentarias, incluidas las pérdidas de preñeces de embriones manipulados.